Higher Intakes of Potassium and Magnesium, but Not Lower Sodium, Reduce CVD Risk | Hacker News Reader

Higher Intakes of Potassium and Magnesium, but Not Lower Sodium, Reduce CVD Risk

pubmed.ncbi.nlm.nih.gov

72 pointsbirriel79 comments

Anecdata, so take it for what it's worth...

But I have high blood pressure, and I've noticed that magnesium supplementation had a larger impact on my readings (in a good way, lower blood pressure) than anything else I tried, including the actual drugs the DR would prescribe (in my case - ACE inhibitors such as Losartan or Lisinipril).

Which is actually pretty astounding, given that the current accepted practice in modern medicine is moving the opposite direction - Diuretics prescribed for high blood pressure often cause low potassium as a side effect (potassium recovery in the kidneys is harmed at the expense of more quickly removing salt/water). And magnesium supplementation is usually warned against (somewhat ironically: because it tends to lower blood pressure even further, and in combination with the drugs can cause problems).

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My take: it's not profitable to solve problems with easily available solutions, and so there is little incentive to fund studying it.

Blood has a few major metals - Iron, Magnesium, Sodium, Potassium, Calcium and Iron. Reduce heavier metals (sodium, iron) in your diet and you should be okay with blood pressure and anxiety. I have a higher than normal blood pressure (and anxiety) since my 20s.

Cant edit. These are my personal opinions and not medical advice

"heavier metals (sodium"

wtf

sigh

logs out

I really wished this had worked for me. I was right on the line of high blood pressure. I would have good days and bad days. Once the bad days started to outweigh the good, my in-laws suggested a magnesium supplement. I tried that for a few months to no avail. I'd feel much better with a natural solution.

Did you try adjusting the dosage, changing which type of magnesium you were supplementing with, or a potassium supplement instead or in addition?

From what I have read, they don't recommend supplements. They recommend getting both magnesium and potassium from foods themselves saying that it works better.

My BP was borderline, and it lowered by 10-15 pts just by eating lots of potassium and magnesium rich foods.

If anything foods with these chemical elements in them seems to be about the most natural solutions I can think of. Even more natural than an artificially produced supplement.

Thusbpartiallyvworked fornme too to the point i currently supplement 40% of the magnesium rda and 20% potassium rda in addition tobregular dietary intake.

This is in line with what I've heard about sodium in the diet, which is that it's not bad in itself, but in proportion to your potassium intake.

I'd guess most Americans are deficient in magnesium and potassium, especially anyone who exercises regularly. If you're a male athlete, your actual magnesium need for example is about 800mg, which is twice the RDA of 400mg, which you're probably also not meeting.

I've helped people cure their chronic anxiety by noticing that they ran for an hour most days, and were taking zero supplemental magnesium.

I thought 300mg supplementation was the max your body could absorb each day.

If you do a lot of sport, you should take more than that?

I don't know about magnesium specifically but I know there were experiments with calcium showing that supplementation both a) didn't absorb 100% of whatever you took, and b) had an upper limit for what could be absorbed over N hours. At a certain point you just have to eat food with calcium in it. I wouldn't be remotely surprised to find that's true for most/all micronutrients.

Supplementation can help, sometimes, but will always be a fraction as impactful as a healthy, well-rounded diet.

You can also take vitamin D3 to increase your calcium absorption.

IIRC, calcium uptake from the intestines is boosted by the presence of fatty acids. Different types of magnesium supplements have different absorption rates (e.g., magnesium oxide vs magnesium glycinate).

Calcium and magnesium share some pathways for absorption and compete with each other. Not only is there a limit to how much calcium or magnesium you can absorb, but if you have a high-calcium diet, your body will absorb less magnesium.

There are other minerals which have this kind of competition, so supplementing with one mineral can cause problems with absorption of another.

Even to the extent that that may be true, it is going to be an average: different people's bodies will be different in what they can absorb, and the same body at different times will be different. Sometimes dramatically, particularly if you have a deficiency.

Most endurance athletes I knew equated bananas with potassium and carbs, but they're not a bad source of magnesium either.

Bananas are okay, nothing magical, speaking as a pretty good badminton player. Genetics is a big deal in athletics. You have to supplement whatever your parents didn't pass on to you.

Bananas are a passable source of potassium only when ripe. That quickly converts to sugar in a day or two. By the time light brown spots appear, most potassium is gone. Sunflower seeds and avocados are far better sources.

Are you thinking of fiber? Potassium is a metallic element. It can't be turned into sugar.

I think I am, yeah. The potassium benefit vs sugar content lessens as they ripen. They never actually LOSE the potassium as I stated.

Where do you get 800mg of magnesium from? I just checked my multi-vitamin and it has 0 potassium and only 120mg of magnesium - my guess is to limit how much you end up just pissing out the first few hours after taking it.

coincidentally i spent much of monday investigating the answers to that question

supposedly magnesium costs about 25¢/kg as caustic-burned magnesia https://pubs.usgs.gov/myb/vol1/2018/myb1-2018-magnesium-comp..., but that includes lots of impurities, probably including lead; you wouldn't want to eat it

the cheapest reasonably food-grade source i've found is probably food-grade magnesium chloride for supplements; it's hard to tell how much you're getting because magnesium chloride exists in various hydration states

here in argentina it costs 3.6 dollars per kilogram, which works out to somewhere between 11 and 36 dollars per kilogram of magnesium

the carbonate, the dead-burned oxide, and the hydroxide are also sold by the kilogram as food supplements; they don't have the hydration problem, and the prices i came up with were respectively

- 20 dollars per kg of carbonate and thus 70 dollars per kg of magnesium

- 15 dollars per kg of dead-burned food-grade oxide and thus 24 dollars per kg of magnesium

- 23 dollars per kg of hydroxide and thus 54 dollars per kg of magnesium

other non-food-grade sources i found in my search included galvanic protection anodes for hot-water heaters (35–44 dollars per kg); magnesium sulfate for bath salts, laxative, or fertilizer (17 dollars per kg of magnesium for the fertilizer, 24 for the bath salts); dolomite as fertilizer (20 dollars per kg of magnesium); and magnesium carbonate chalk as exercise equipment (91 dollars per kg of magnesium)

(my reason for this search was for formulating carbon-neutral cements, not supplementing my dietary magnesium, so i'd be delighted to find a non-food-grade source that was closer to 24¢ than 24 dollars)

24 dollars per kg of the oxide is 2.4¢ per gram

the chloride is highly water-soluble (you have to store it in a hermetically sealed container to prevent deliquescence; i bought a kilogram hermetically sealing jar from the health food store) so it's very easy to add to food. unfortunately it makes the food taste like horse shit, or more precisely like chewing on rubber bands, because those magnesium ions are extremely bitter

the oxide and hydroxide are almost perfectly insoluble in water, and the carbonate nearly so, and consequently they will not make your food taste like an accident in a quinine factory. they're just a little chalky. stomach acid converts them to the chloride, which is why mylanta is largely magnesium hydroxide

the other thing to keep in mind, aside from disturbing your stomach acid homeostasis, is that magnesium is a laxative. mixing it with food instead of taking it by iteslf helps with this. however, you don't want to mix it with food which is a good source of phosphate, such as coca-cola or high-phytate plants like flaxseed or beans, because the magnesium phosphate thus produced in your stomach has basically zero bioavailability. it doesn't matter if the phytate gets broken down by cooking because what it gets broken down to is phosphate

the oxide brand is a local argentine thing called 'natural whey', so you won't be able to find it abroad https://articulo.mercadolibre.com.ar/MLA-1165077489-oxido-de...

I would expect extremely poor bioavailability for dead-burned magnesium oxide. It's called "dead" burned because it has very low chemical reactivity when it's been heated that intensely.

don't eat the not-dead-burned version; the most common kind is as caustic as lye and will cripple you for life by burning your esophagus

'very low chemical reactivity' turns out, in context, not to mean that it resists being digested by stomach acid, so the bioavailability of the dead-burned type is just fine; this experiment came up with a figure of 43% https://pubmed.ncbi.nlm.nih.gov/2407766/

if it were 4% or 0.4% i would agree

That's higher than I expected. Thanks for the citation!

I take potassium and magnesium supplements in order to compensate for some preparation methods that I use to remove some undesirable substances from some vegetables, e.g. starch and phytic acid, but which end with a washing that will also remove some water-soluble substances like potassium and magnesium.

I have experimented with many variants, but I have eventually settled to use potassium citrate powder and magnesium bisglycinate powder.

I add these powders to the food together with the table salt. The daily intake costs me about 30 cents for both of them. It could be cheaper if I would buy them in greater amounts, but it does not make much sense, because even a box with 200 g to 400 g of powder would be enough for many months and if I would buy e.g. 1 kg I would need more than a year to consume it and there might be some degradation after all that time. I prefer pure powder because it is not only cheaper, but it also does not contain useless or maybe even harmful excipients, like pills or capsules.

I have also tried magnesium citrate, which is cheaper, but I have switched to bisglycinate because the latter is soluble in water (so like the common salt and the potassium citrate it disperses easily to attain a uniform concentration in the entire food) and it is also unlikely to form insoluble precipitates with any component of food (magnesium chloride will form insoluble precipitates with phosphate and with some organic acids from food), so it has the best chances for intestinal absorption.

Neither magnesium citrate nor bisglycinate modify the taste of the food, because the citrate is almost insoluble, while in the soluble bisglycinate the magnesium ions are not free, but chelated (i.e. surrounded) by glycine molecules. With magnesium citrate sometimes there was a mild laxative effect, because the stomach acid dissolves it and free magnesium ions reach the intestine. With bisglycinate I have not noticed anything, because it is not decomposed prior to absorption.

You can also put these powders directly in (hot) water as a tea-like drink. On their own they’re a little bitter (but IMO not unpleasantly so), but you can combine them with an actual tea (or something by sweet like squash) at which point the taste modification is quite mild

Nuts: walnuts, cashews, almonds, sunflower seeds

My working assumption about multivitamins is that they contain enough of a given vitamin/mineral to _say_ it's in there, but not enough to cause problems caused by an excess of that nutrient. Which makes them not very useful for nutrients which are commonly quite low in the common diet (like magnesium).

Magnesium, for example, is a laxative in higher doses. If you're selling a multivitamin, you don't want to be giving your customers diarrhea, so you run the numbers and put in just enough magnesium so that your customers will get the benefits of your product without tipping the scales into diarrhea-ville.

On a side note, if your multivitamin is using magnesium oxide, it's barely getting absorbed by the body anyway.

The better magnesium forms (like citrate) tend to be very voluminous. They might not want to make multivitamin pills large because people tend not to like that. That's my personal hypothesis. (People who have decided that they want magnesium specifically and are informed about the better forms will just (have to) accept the bigger pills.) Also, price probably plays a role.

arcanemachiner says >" if your multivitamin is using magnesium oxide, it's barely getting absorbed by the body anyway."<

Magnesium oxide works fine.

Suffered repeated bouts of cramps after hard swim workouts for 15 years (Masters' swimming). One day driving home a guy on the radio explained that you need as much magnesium as calcium. I began taking magnesium oxide. Results: no more cramps, breathholding ability way up and enjoyed a far more relaxed swim stroke.

Did you take MO as part of a multi or just as a standalone supplement?

I was taking a calcium pill (eating bananas too for K) and wondering why my cramps persisted. I added MgO and (poof) the cramps vanished and other good side-effects appeared immediately.

Though Ca and Mg are often combined, some combinations may be marketed differently. For example "Rolaids" is sold primarily as an antacid but is little more than calcium:magnesium oxides in the ratio 1:5. It tastes better than most CaMg supplements so, if someone wants to merely try a supplement, I recommend Rolaids!

Most Ca+Mg supplements have a ratio 1:2 of the oxides.

I buy magnesium glycinate by the kilogram and just scoop the powder, aiming for a gram (2200mg of magnesium) by the kilo it costs 30-35 dollars, it's practically free as far as supplements go so I don't really care if I'm pissing most of it out, although it doesn't seem like I am. I am hesitant to mention the place I buy from because this doesn't seem like the place that looks kindly on promoting supplement companies. The only thing I ever ran into supplementing magnesium was disaster pants from choosing the wrong one (i.e. magnesium citrate, but I am sure others cause disaster pants at low doses too)

Thank you! Probably sodium makes blood heavier and the heart has to work harder to pump it. I've had the same thinking about higher haemoglobin numbers (which I do, i am at too high HB for men) and I do suffer from borderline higher blood pressure since my adolescence (not to mention anxiety). Probably I should start taking more Magnesium to balance the minerals. Read somewhere on the internet that we need to balance the metals in our blood. Sodium, Potassium, Magnesium, Iron and Calcium lead to a healthy CVS system.

Not medical advice, but for folks looking to supplement with Mg, it's best to avoid Magnesium oxide, as it is very poorly absorbed. Magnesium chloride and Magnesium bisglycinate are much better absorbed.

There are charts out there showing the bioavailability of different compounds. As a rule of thumb, the oxide versions of a mineral (e.g. magnesium oxide, zinc oxide) are often the cheapest and least bioavailable versions.

I’ve had the best luck with magnesium threonate.

Furthermore, magnesium levels in soils are typically fairly depleted, so the FDA labeling for fruits and vegetables is often incorrect (having been measured a long time ago).

What doesnt make sense is the role the kidneys are not playing in a high sodium diet.

Sure there is the sodium potassium pump in cells, but what are the kidneys doing as they should be clearing the sodium, maintaining the balance.

It's certainly true that most people are deficient in potassium. The daily recommended dose for males is over 3 grams per day![1]

To make matters worse, the FDA limits the amount of potassium that can be present in supplements to 100mg[2]. So good luck taking 30 supplements to meet your daily requirements!

One option Id like to advertise is salt alternatives at grocery stores which are filled with potassium, some with at least 800mg per tsp. This can be another way to supplement potassium and magnesium in the diet [2]

[1] https://ods.od.nih.gov/factsheets/Potassium-HealthProfession...

[2] https://www.health.harvard.edu/staying-healthy/should-i-take...

No one never explains how to get 3000 mg of potassium a day and potassium is usually a very small part of multivitamin supplements. It makes me slightly skeptical of that number.

It's in a surprising amount of foods, people usually think bananas but it's in many fruits/vegetables, chicken, fish, in pretty high quantities

Bananas are for carbs and electrolytes. If you just want electrolytes, kiwis have a much higher ratio.

I’ll be darned. I missed that.

Now try getting the full daily amount in

It depends on what you eat. A person eating a lot of tomatoes, legumes, potatoes, and squash would hit it pretty easily, which is common for a lot of traditional diets (south asia, some parts of latin america, etc).

Thank you. I wasn’t able to come up with the right mix but other posts along with yours are telling me I should re-double my research.

You are supposed to get it through eating a varied diet including potassium rich foods every day, typically.

This is part of the "5 servings per day" idea for fresh fruits and vegetables.

For example a banana and a cup of cooked spinach get you nearly 1/2 way there in 2 servings.

OK I clearly need to repeat my research. This gives me hope, thanks!

Potassium is in a lot of foods. I know this very well because I spend many years on dialysis due to kidney failure and had to do a lot of diet tracking so I didn't consume too much potassium or phosphorus because the kidneys are important in removing excess amounts. Most meats, vegetables and fruits, nuts legumes all have potassium of a varying amount.

Also the USDA maintains a database of complete nutrition of many common foods.

https://fdc.nal.usda.gov/

For fun, I asked Chat GPT to come up with a daily diet to hit the DRV number. It had a banana, potatoes, chicken, salmon, black beans, spinach, broccoli, an avacado, and a few other things. So it is "doable".

Does it satisfy all other dietary recommendations though? I saw some people saying that it's actually impossible to satisfy the potassium value simultaneously with all the other dietary recommendations, using natural food.

I wouldn't be. A lot of people have worked hard on these numbers over the years.

I'm guessing the limitation on supplements assumes a good diet (no shortage of advice from USDA on 'good' and potassium sources) which typically provides the recommended intake. However there can of course be days that's not possible.

I used to supplement with potassium salt powder. A teaspoon was like 5000-10000mg if I’m remembering right. I was very uncomfortable having it in the house, I think a couple tablespoons would likely stop the heart of an adult. I think it’d be very unpleasant to consume that much, but I didn’t test the theory.

I left a 1/8 tsp permanently in the bottle so there can be no mistake about what does to use.

Potassium chloride is what they use to stop mammal hearts in euthenasia/capital punishment.

I think the FDA might have some reasons to prefer potassium be spread out across meals instead of taken in a lump sum all at once (think also, children eating vitamins as candy. I know someone who almost died of iron poisoning as a child before they made the pills bitter)

That’s intravenous KCL. Significantly different absorption than taking it orally. Wikipedia is showing a roughly 100x difference in the LD50 of oral vs intravenous.

If you tried to ingest a lethal dose of KCL, I would put huge odds on you first retching out you guts. ~190 grams orally to hit the LD50

I participated in a "crank science" study, where a bunch of us took salt alternative daily to see if the added potassium explained the success of the so-called "potato diet".

Salt alternatives taste like sipping a freshly blended nine volt battery. My big contribution to the project was discovering that the stuff is mostly tolerable when dissolved in cranberry juice.

https://slimemoldtimemold.com/2022/12/20/people-took-some-po...

I mix potassium-based salt alternative into my food and I barely notice it.

Fun fact: The potassium salt is mildly radioactive: http://large.stanford.edu/courses/2015/ph241/gilpin1/

You can also buy potassium chloride water softener pellets. On the Lowe's site I currently see a 40 pound sack for $40. I used to grind them up in a coffee maker for making my own custom lower-sodium salt blend for cooking.

The potassium salt tastes disgusting (try a pinch!). That is my main blocker for having more of it via this route.

> To make matters worse, the FDA limits the amount of potassium that can be present in supplements to 100mg[2]. So good luck taking 30 supplements to meet your daily requirements!

You don't need nearly 30 pills, even with a poor diet. Almost all foods, even junk foods, have some amount of potassium. Per 100g (3.5oz), a random sampling from my typical snacks, lunches and breakfasts:

  chicken breast       223mg
  cooked white rice    35mg
  cooked pasta         24mg
  1 large egg          69mg
  whole milk           132mg
  apple                107mg
  bagel                165mg
  almonds              705mg
  banana               358mg
  Miss Vickie's Sea Salt & Vinegar Flavored Potato Chips  1260mg

Potato chips are high in potassium and have a close to ideal 2:1 ratio of potassium to sodium. Superfood!

Lol why potato chips? Why not just potatoes?

I eat potatoes most days, usually just boiled, sometimes baked to help get more potassium.

When salt=death was a thing in the 80's and early 90's, one of the 'solutions' was to substitute sodium chloride for potassium chloride. Sounds like we were accidentally fixing the wrong problem.

I just did some quick research, and here are some common foods that are naturally rich in magnesium. In addition a lot of cereals like shredded wheat, oatmeal, bread also have mg. Looks like some delicious options. There was also a note in the article about that you can't absorb too much Mg through these sources.

* Almonds, dry roasted: Serving Size 1 oz, 80 mg

* Spinach, boiled: Serving Size ½ cup, 78 mg (does it have to be boiled?)

* Cashews, dry roasted: Serving Size 1 oz, 74 mg

* Peanuts, oil roasted: Serving Size ¼ cup, 63 mg

* Black beans, cooked: Serving Size ½ cup, 60 mg

* Edamame, shelled, cooked: Serving Size ½ cup, 50 mg

* Dark chocolate -60-69% cacoa: Serving Size 1 oz, 50 mg

* Peanut butter, smooth: Serving Size 2 tablespoons, 49 mg

* Avocado, cubed: Serving Size 1 cup, 44 mg

https://my.clevelandclinic.org/health/articles/15650-magnesi...

Wow this is timely, I was just researching potassium and magnesium supplements a few days ago.

It seems like potassium supplements are useless because they're limited to 100mg by law and the way to go may be potassium based salt substitutes, which you can buy in bulk and take as much as you need. Some people talk about the danger of hyperkalemia but it seems to me like it's actually very difficult to cause that with supplementation unless your kidneys are malfunctioning.

What is the best way to supplement without causing digestive issues?

If you're an athlete, I'd recommend LMNT. It's easy to make yourself, tastes great, and easy on the stomach.

Here's my recipe (all bought in bulk in a very fine powder form - they need to be consistent particle sizes so they mix well) which should be fairly close to LMNT, although a chemist will probably tell me I'm wrong:

20g magnesium malate

20g potassium chloride

142g salt

140g citric acid

15g stevia powder (pure, not mixed with some other sweetener)

20g artificial flavoring powder (not affiliated, but I have used black cherry powder from naturesflavors.com with good success)

Mix it up and then put 1 tsp in 20-32oz water. Should last you a long while.

Where do you purchase the magnesium and potassium from?

Late response (not sure how to get notified of replies) but I just grabbed 16oz of each from Amazon.

As a non-expert in this field of science, Id caution taking any single study or paper, and perhaps even any single meta-analysis, as an uncertain data point rather than something that determines life decisions.

Wading through all the data, how it was interpreted, and what the pitfalls might be, is extremely complex for epidemiology and in fact any human study.

Science is a self-correcting process, but for there to be corrections there must be errors first!

There was an error first. "Salt==bad."

An error first does not preclude a subsequent error either. Best to wait for replication, refutations, etc.

Does Calcium supplementation lead to higher levels of arterial plaque? I ask because I take a combined Magnesium/Calcium supplement.

https://www.healthyfood.com/ask-the-experts/the-sodium-potas... - i've heard that you need to balance potassium and sodium for ideal health.

Vaguely related, fasting depletes potassium and can make your cardio vascular system really tense and weak.

I can add an anecdotal data point to this. Intermittent fasting only started mildly working for me without making me feel weak and head-achy when I re-added electrolytes in the form of dill pickles, Lipton cup of soup or high enough dose supplements (Gatorade is not enough), especially before sweaty physical activity.

Coconut Water tends to have a good amount of Potassium in it if you're deficient and want something "pre-mixed".

Wait a few weeks and a study showing the opposite will come out.

There are plenty of other studies showing a strong correlation between sodium and stroke risk and this study focused on overall CVD risk, so it's still a good idea to avoid high sodium intake.

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